A novel approach to mitigate muscle atrophy in Guillain-Barre syndrome

Abstract

Guillain-Barre syndrome (GBS) is the most common cause of acute paralytic neuropathy worldwide. GBS manifests as rapidly progressive, symmetrical numbness, paresthesia, and weakness secondary to either peripheral nerve demyelination or axonal loss. Despite effective disease modifying therapies (e.g., intravenous immunoglobulin) and individualized rehabilitation programs, many individuals recovering from GBS experience substantial muscle atrophy and incomplete recovery of strength with resultant long-term functional impairment. This narrative review explores the therapeutic potential of omega-3 fatty acid supplementation on enhancing recovery of people with GBS. This purported benefit may occur through several potential mechanisms, supported indirectly through studies using both experimental animal and clinical human models. These mechanisms include: (i) Anti-atrophic effects on skeletal muscle undergoing disuse and systemic inflammation; (ii) the use of omega-3s as a key building block comprising myelin; (iii) immune modulating effects optimizing conditions for remyelination; and (iv) preventing excitotoxic-like neuron death. The physiological mechanisms are explored in detail with examination of relevant clinical trials conducted to date. Through this exploration, there is sufficient support to justify future investigations directly examining the role omega-3 fatty acid supplementation may play as an adjunctive intervention that could have significant benefit at low cost and minimal risk of adverse events.